The middle ear is an air-filled cavity which is sealed by the eardrum and contains the chain of three small bones called the malleus (hammer), incus (anvil) and stapes (stirrup). The Eustachian tube connects the middle ear to the back of the nose and ventilates it.
Surgery is sometimes possible to improve the hearing. Usually this is possible when there is a problem with the small bones (ossicles) in the middle ear which may be partially removed or replaced. Most ear surgery is microsurgical, performed using an operating microscope to enable the surgeon to view the very small structures of the ear under general anaesthesia. It may be carried out down the ear canal without any incisions if access is adequate.
The stapes (stirrup) bone sometime becomes fixed with new bone growth around its edge so causing hearing loss. Partial removal and drilling a microstapedotomy through the footplate allows a piston to be inserted to contact the fluid of the inner ear. This restores the conduction of vibrations from the ear drum through to the inner ear. Sometimes hearing loss is caused by damage to some of the other ossicles which can be replaced or repaired with artificial prostheses made of titanium, artificial bone-like material or plastic.
If the eustachian tube becomes blocked in adults, sometimes by a simple cold, fluid builds up in the middle ear causing hearing loss. This fluid can be drained by making a small incision in the ear drum usually under local anaesthetic, draining the fluid and then inserting a grommet (plastic tube) into the ear drum to provide the required ventilation. Alternatively, a less invasive procedure is a balloon eustachian tuboplasty (BET). This is where a balloon is inserted through the nose into the eustachian tube to dilate it. This is also useful to treat patients who have symptoms of ear fullness or blocking and problems equalising their ears on a flight or while diving.
Hearing aid technology continues to advance and can help more and more people in a less conspicuous way. They are often the first choice in treating a more permanent type of hearing loss.
Bone conduction hearing implants (BCHI)
may be appropriate if there are middle ear problems or for the treatment of single sided deafness.
The key to successful amplification is the independent advice from an experienced clinician. Our audiology colleagues can offer the latest technologies and devices tailor made to each patient’s unique requirements.
Stapedotomy
Grommet Information
